Anastomosis is a procedure where two separate tubular or hollow organs are surgically grafted together to form a flexible conduit. In a coronary artery bypass graft (CABG) procedure, one end of the graft vessel is usually attached to the aorta and the other to the coronary artery to bypass the blocked area and reroute blood flow to the heart. Prior to an anastomotic procedure between the coronary artery and the graft vessel, a surgeon usually creates an incision in the coronary artery before the graft vessel is attached. This incision is known as an arteriotomy. Currently, creating an arteriotomy requires the use of separate tools to penetrate the vessel and create the incision. The use of multiple tools to complete a simple task such as creating an arteriotomy can lengthen the amount of time a patient spends in the operating room. Accordingly, a need exists for a tool that is capable of performing both functions of puncturing the vessel and creating the incision within the same vessel.